Is NBRHC in danger of having to close its emergency department?

Even as more and more Ontario emergency departments are forced to close for periods due to staffing shortages, the North Bay Regional Health Centre does not anticipate such an outcome for its patients.

"The NBRHC Emergency Department is very unlikely to close," says Dr. Alexis Lemmex, Interim Chief of Emergency Medicine. "We are a regional hospital and we staff ourselves accordingly. We have physicians covering 24/7 and that goes for our nursing colleagues, as well."

See related: Ontario hospitals warn of more upcoming ER closures through the summer

Lemmex acknowledges that NBRHC is experiencing pressures similar to other Ontario hospitals when it comes to staffing. "We are feeling the strain. On occasion, some shifts do go unfilled but there is always a physician available to see patients 24/7."

The fact is, according to CIHI, one in four physicians in Ontario is over the age of 60 says Lemmex, "and combined with the stresses of the pandemic, there have been significant staffing shortages throughout."

And: Ontario opposition calls on government boost health spending in light of ER closures

The health care exodus is real and Lemmex says it is evident by the number of both departing nurses and physicians. "We've managed to recruit some physicians over the last few years, so we are currently able to appropriately staff our department."

Still, visits for emergency take more time with less staff. It is important for visitors to emergency departments to recognize the most injured and sick patients will be seen first. "Sometimes patients will wait a little longer than we would like to see," she says.

See also: Ontario municipal leaders call for action amid several temporary ER closures

Lemmex observes the strain seen from physicians to nurses and support staff is "multi-factorial," adding the "emergency room is the safety net of any hospital — and our health care system. When things aren't going well from the health care system's perspective, we tend to feel all the pressure."

She points to the surging number of ALC beds — atypical for this time of year — NBRHC is seeing. Lemmex cites an Ontario Hospital Association report stating one in six hospital patients could go elsewhere for their care if there was adequate space.

"That's a ricochet effect and we see it in our department. Those ALC patients are now occupying emergency room beds and those are beds we could be using to see more patients. Those patients need to be somewhere so they have a bed in our emergency room and are cared for by emergency room nursing staff." 

The strain is felt in most facets of the health care system and often trickles down to the emergency department, says Lemmex who salutes "all our people who play such a valuable role in our health care system. But, when we don't have the staff to run things like blood tests, things just take a little bit longer."

See: 'A nurse can't be everywhere': Health care staff shortages prompt Ontario ER closures

Lemmex has no immediate fixes for the state of the system.

"I do know, in our Emergency Department, we are good at being creative and doing what we can with what we have. We've always prided ourselves on that and I think we're really good at doing that in North Bay."

Human resources will play a large factor, Lemmex maintains. Training more physicians, attracting students to medical school and making sure those future physicians have the mentors necessary for growth are key. In North Bay, specifically, generalists are needed who can run a family practice and take shifts in emergency, says Lemmex, and a direct path to finding those doctors is to find and train people from our own community.

"That's why NOSM University is such a great medical school because they train people in the north and the people tend to stay in the north. The health care shortage does affect the north more than other areas."

Maintaining a balanced professional and personal life has become a necessity as Dr. Lemmex and her husband (also a physician) have three children under the age of four. 

"We're busy but I love my job. I love coming to work every day," she says. "Of course, we're tired but we're so fortunate to live in such a beautiful community and I can spend days off at the beach."